Mikuniya A, Sawai M, Murayama S, Sakamoto Y, Fukushi T, Sasaki M, Mikami M, Onodera K, Oike Y
Second Department of Internal Medicine, Hirosaki University School of Medicine.
J Cardiol. 1991;21(4):827-33.
The significance of coronary collateral circulation for redistribution in the infarcted zone was evaluated in 16 patients with history of myocardial infarction and severe stenosis (> or = 90%) of the coronary artery. Redistribution areas were quantitatively measured using the redistribution ratios and redistribution indices on the infarction-redistribution map obtained by thallium-201 scintigraphy with single photon emission computed tomography. Coronary collateral findings were categorized in 4 classes according to the Rentrop's grading. There was good, positive linear correlation between the redistribution ratio (Y) and collateral grading (X) (Y = 0.21X + 0.10, r = 0.92, p < 0.01). The redistribution index (X) also correlated well with the collateral grading (Y) using a good, positive quadratic equation (Y = 0.32X2 + 0.24X + 0.04, r = 0.89, p < 0.01). These results suggest that the measurements of the redistribution areas in the ischemic zone in myocardial infarction correlated well with collateral perfusion. Collateral perfusion severer than Rentrop's grade 2 markedly reduces the severity of ischemia and increases redistribution areas.
在16例有心肌梗死病史且冠状动脉严重狭窄(≥90%)的患者中,评估了冠状动脉侧支循环对梗死区域再分布的意义。通过201铊单光子发射计算机断层扫描获得梗死 - 再分布图像,利用再分布率和再分布指数对再分布区域进行定量测量。根据Rentrop分级将冠状动脉侧支情况分为4类。再分布率(Y)与侧支分级(X)之间存在良好的正线性相关性(Y = 0.21X + 0.10,r = 0.92,p < 0.01)。使用良好的正二次方程,再分布指数(X)与侧支分级(Y)也具有良好的相关性(Y = 0.32X² + 0.24X + 0.04,r = 0.89,p < 0.01)。这些结果表明,心肌梗死缺血区域再分布面积的测量与侧支灌注密切相关。侧支灌注比Rentrop 2级严重时,可显著降低缺血严重程度并增加再分布面积。